STACEY M SACKSNER Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****41

License Status

ACTIVE

Business

First Name

STACEY M

Last Name

SACKSNER

Business Name

STACEY M SACKSNER

Original Issue Date

09/26/1988

Effective Date

08/04/2024

Expiration Date

09/30/2027

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/04/2024